Influence of Autonomy on Motor Learning in People With Parkinson's Disease

Обзор

The goal of this clinical trial is to explore the benefits of autonomy supported learning in patients with Parkinson's disease. The main questions to answer are: * Whether autonomy supported learning can benefit motor learning in PD patients * Whether autonomy supported learning can enhance intrinsic motivation and/ or information processing of PD patients in learning a new task. * Whether autonomy supported learning can facilitate cortical excitability change after practicing a new task. Participants will be recruited into two groups (Self-control group, SC; and yoked group, YK) to learn a finger-pressing trajectory matching task * Participants in SC group will have choice over feedback schedule during trial practice * Participants in YK group will receive feedback with no-choice during trial practice Researchers will compare the retention test performance to see if autonomy supported learning will lead to better learning effect.

Подробное описание

Autonomy is the sense of learner to actively participate in determining their own behaviour. The present study aims to investigate whether an autonomy supported practice (with self-controlled feedback) would benefit adults with Parkinson's disease (PD), along with increased intrinsic motivation, information processing and cortical excitability. Two groups of healthy adults and two groups of PD patients will be recruited to learn a finger-pressing trajectory matching task. Participants will be allocated in either a self-control group (choice over feedback schedule), or a yoked group (receive feedback with no-choice). Learning will be assessed on the second day and one week later, along with an error estimation of learners' own performance to represent their information processing ability. Cortical excitability and inhibition will be assessed via transcranial magnetic stimulation as indicators of cortical plasticity. Questionnaire regarding motivation will be assessed before and after practice trials. Study hypothesized that individual with PD would benefit from autonomy supported learning, with better performance, enhanced motivation and information processing, associates with change of cortical excitability

Вмешательства

• Поведенческое Autonomy supported learning
  The ability of learners to participate in determining their own behaviour, which is the feedback schedule regarding their practice performance in this study.
• Поведенческое Practice with predetermined feedback
  Learners practice the motor task, while the feedback is provided according to their counterpartner

Первичные конечные точки

• Performance accuracy [Срок оценки: up to day 7]

Вторичные конечные точки (3)

• Intrinsic Motivation Inventory [Срок оценки: day 1, day 2, day 7]
• Error Estimation [Срок оценки: day 2, day 7]
• Cortical excitability changes [Срок оценки: Baseline, day 2, day 7]

Критерии участия

Критерии включения

• age above 20-years-old
• able to follow instructions to perform the tasks (Montreal Cognitive Assessment ≥ 24)
• no surgery and injury in upper extremities in recent 6 months

Критерии исключения

• other neurological disorders in addition to Parkinson's disease
• Parkinson's disease dementia
• symptom of severe tremor in upper extremities (score ≥ 3 in Question 15 to 18 of UPDRS-III)
• deep brain stimulation or pacemaker implanted
• medical history of seizure
• a blood-relative with history of epilepsy
• unstable medical conditions
• pregnancy

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Распределение

Нерандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

Тайвань · 1 центр

• National Taiwan University Hospital — Taipei

Публикации

• Carter MJ, Ste-Marie DM. Not all choices are created equal: Task-relevant choices enhance motor learning compared to task-irrelevant choices. Psychon Bull Rev. 2017 Dec;24(6):1879-1888. doi: 10.3758/s13423-017-1250-7. PMID 28224481
• Chiviacowsky S, Wulf G, Lewthwaite R, Campos T. Motor learning benefits of self-controlled practice in persons with Parkinson's disease. Gait Posture. 2012 Apr;35(4):601-5. doi: 10.1016/j.gaitpost.2011.12.003. Epub 2011 Dec 30. PMID 22209649
• Lim DJ, Tai CH, Chen SY, Huang CY, Lee YY. Self-Controlled Feedback on Motor Learning and Neuroplastic Changes in People With Parkinson Disease. J Neurol Phys Ther. 2026 Jul 1;50(3):166-173. doi: 10.1097/NPT.0000000000000553. Epub 2026 Apr 17. PMID 41992310

Идентификаторы

NCT: NCT05960331 · 202304047RINC

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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